Cutting guard with ground connection

ABSTRACT

A tissue guard for use with a surgical access device includes a proximal ring having proximal and distal ends, the distal end configured to operably couple to a ground ring that ultimately electrically connects to an electrical ground. One or more mechanical interfaces extend about the proximal ring and are configured to mechanically engage a rim of an access device to secure the tissue guard thereon. A retention body is configured to operably couple to a distal end of the ground ring, the retention body including a distal end configured to operably engage the access device to secure the tissue guard therein.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.16/900,257, filed on Jun. 12, 2020, the entire contents of which arehereby incorporated herein by reference.

FIELD

The present disclosure relates to tissue specimen removal and, moreparticularly, to surgical access devices, tissue guards and systemsincorporating the same for use in tissue specimen removal procedures andother surgical procedures.

BACKGROUND

In minimally-invasive surgical procedures, operations are carried outwithin an internal body cavity through small entrance openings in thebody. The entrance openings may be natural passageways of the body ormay be surgically created, for example, by making a small incision intowhich a cannula is inserted.

Minimally-invasive surgical procedures may be used for partial or totalremoval of tissue from an internal body cavity. However, the restrictedaccess provided by minimally-invasive openings (natural passagewaysand/or surgically created openings) presents challenges with respect tomaneuverability and visualization. The restricted access also presentschallenges when large tissue specimens are required to be removed. Assuch, tissue specimens that are deemed too large for intact removal maybe broken down into a plurality of smaller pieces to facilitate removalfrom the internal body cavity. Typically, a surgical sleeve and aspecimen containment bag are used for this purpose. Moreover, duringspecimen rescission, smoke may cloud the operating site and may requireevacuation therefrom. Smoke evacuation systems are commonplace for usewith the surgical sleeve.

SUMMARY

As used herein, the term “distal” refers to the portion that isdescribed which is further from a user, while the term “proximal” refersto the portion that is being described which is closer to a user.Further, any or all of the aspects described herein, to the extentconsistent, may be used in conjunction with any or all of the otheraspects described herein.

Provided in accordance with aspects of the present disclosure is atissue guard for use with a surgical access device which includes aproximal ring having proximal and distal ends, an inner peripheralsurface having one or more channels defined therein disposed in fluidcommunication with an operating cavity, and a plurality of fingersextending about the proximal ring, each finger configured tomechanically engage a rim of an access device to secure the tissue guardthereon. A ground connection assembly is configured to operably coupleto the distal end of the proximal ring, the ground connection assemblyincluding an electrically conductive ground ring disposed on an innerperipheral surface thereof electrically coupled to a ground wireconfigured for ultimate connection to an electrical ground. A retentionbody is included having proximal and distal ends, the proximal end ofthe retention body is configured to operably couple to the distal end ofthe ground connection assembly and the distal end includes a pluralityof spaced-apart tabs extending therefrom configured to operably engagethe access device to secure the tissue guard therein.

In aspects according to the present disclosure, the plurality ofspaced-apart tabs of the distal end of the retention body each include aplurality of ridges defined therearound to facilitate retention of thetissue guard within the access device.

In aspects according to the present disclosure, the proximal ringincludes an annular channel defined therein and a connection portdisposed thereon in fluid communication with the annular channel andadapted to connect to a smoke evacuation system.

In aspects according to the present disclosure, the plurality of fingerseach include a lower flange configured to operably engage the accessdevice. In other aspects according to the present disclosure, theplurality of spaced-apart tabs are scalloped to facilitate engagementwith the access device. In still other aspects according to the presentdisclosure, each of the spaced-apart, scalloped tabs includes aplurality of ridges disposed thereon to facilitate engagement with theaccess device.

In aspects according to the present disclosure, the proximal ring isresilient to facilitate mechanical engagement atop the access device.

Provided in accordance with aspects of the present disclosure is atissue guard for use with a surgical access device which includes aproximal ring having proximal and distal ends, the distal end configuredto operably couple to a ground ring that ultimately electricallyconnects to an electrical ground. One or more mechanical interfaceextends about the proximal ring and is configured to mechanically engagea rim of an access device to secure the tissue guard thereon. Aretention body is included and is configured to operably couple to adistal end of the ground ring, the retention body including a distal endconfigured to operably engage the access device to secure the tissueguard therein.

In aspects according to the present disclosure, the retention bodyincludes a plurality of spaced-apart tabs at a distal end thereofconfigured to facilitate retention of the tissue guard within the accessdevice. In other aspects according to the present disclosure, theplurality of spaced-apart tabs each include a plurality of ridgesdefined therearound to facilitate retention of the tissue guard withinthe access device. In still other aspects according to the presentdisclosure, the plurality of spaced-apart tabs are scalloped tofacilitate engagement with the access device.

In aspects according to the present disclosure, the proximal ringincludes an annular channel defined therein and a connection portdisposed thereon in fluid communication with the annular channel andadapted to connect to a smoke evacuation system.

In aspects according to the present disclosure, the proximal ring isresilient to facilitate mechanical engagement atop the access device.

In aspects according to the present disclosure, the tissue guard furtherincludes a plurality of fingers extending about the proximal ring, eachfinger is configured to mechanically engage a rim of the access deviceto secure the tissue guard thereon. In other aspects according to thepresent disclosure, the plurality of fingers each include a lower flangeconfigured to operably engage the access device

BRIEF DESCRIPTION OF THE DRAWINGS

The above and other aspects and features of the present disclosure willbecome more apparent in light of the following detailed description whentaken in conjunction with the accompanying drawings wherein likereference numerals identify similar or identical elements.

FIG. 1A is an exploded, top, perspective view of a prior art systemincluding an access device and a tissue guard;

FIG. 1B is a cross-sectional view of the prior art system of FIG. 1Adisposed within an opening in tissue;

FIG. 1C is a schematic illustration of a smoke evacuation system for usewith one or more of the access devices and tissue guards describedherein;

FIG. 2A is a top perspective view of a tissue guard for use with theaccess device;

FIG. 2B is a top perspective view of the tissue guard of FIG. 2A engagedto a proximal rim of the access device;

FIG. 3A is a top perspective view of one embodiment of a tissue guardfor use with the access device in accordance with the presentdisclosure;

FIG. 3B is a side, cross sectional view of the tissue guard of FIG. 3A;

FIG. 4A is a top, exploded perspective view of the tissue guard of FIG.3A including a funnel body, ground connection assembly and retentionbody;

FIG. 4B is a side, cross sectional view of the funnel body of the tissueguard of FIG. 3A;

FIG. 4C is a side, cross sectional view of the ground connectionassembly of the tissue guard of FIG. 3A;

FIG. 4D is a side, cross sectional view of the retention body of thetissue guard of FIG. 3A;

FIG. 5 is a side, cross-sectional schematic view of another embodimentof a tissue guard in accordance with the present disclosure;

FIG. 6A is a side, cross-sectional schematic view of yet anotherembodiment of a tissue guard in accordance with the present disclosureincluding a clip-on ground return; and

FIG. 6B is a side, cross-sectional schematic view of the clip-on groundreturn of FIG. 6A.

DETAILED DESCRIPTION

Turning to FIGS. 1A and 1B, a prior art system 100 provided inaccordance with the present disclosure includes a tissue guard 110 andan access device 150. Tissue guard 110 is monolithically formed as asingle piece of material, e.g., a biocompatible plastic such as, forexample, polyethylene, polycarbonate, etc., from any suitable method,e.g., injection molding. The material, thickness, and configuration oftissue guard 110 are such that tissue guard 110 defines sufficientstiffness to maintain its shape when positioned within an opening intissue “T” and/or when engaged within access device 150. However, thematerial, thickness, and configuration of tissue guard 110 also providesufficient resilient flexibility to permit manipulation of tissue guard110 from an at-rest position for insertion into an opening in tissue “T”and/or for engagement within access device 150, with tissue guard 110returning to or towards the at-rest position after insertion and/orengagement as explained in more detail below. Further, the material,thickness, and configuration of tissue guard 110 is selected such thattissue guard 110 is configured to withstand cutting and puncturing bysurgical knives, scalpels, pencils, and the like, thereby protectingsurrounding tissue “T” and/or access device 150 from being cut orpunctured. Tissue guard 110 may additionally or alternatively beconfigured to inhibit transfer of thermal and/or electrical energytherethrough to protect surrounding tissue “T” and/or access device 150from thermal and/or electrical energy.

Continuing with reference to FIGS. 1A and 1B, tissue guard 110 includesa body 112 defining an open proximal end 114, an open distal end 116,and a lumen 118 extending therethrough between open proximal and distalends 114, 116, respectively. Lumen 118 defines a longitudinal axis 120and is configured to receive one or more surgical instruments (notshown) therethrough. In embodiments, body 112 defines a funnel-shapedconfiguration wherein a diameter of body 112 at open proximal end 114thereof is greater than a diameter of body 112 at open distal end 116thereof. Additionally or alternatively, the exterior surface 122 of body112 may define a generally concave configuration while the interiorsurface 124 of body 112, which defines lumen 118, may define a generallyconvex configuration.

Access device 150 may be configured as a tissue retractor, an accessport, or other suitable access device configured for positioning withinan opening in tissue “T,” e.g., a surgical incision or anaturally-occurring orifice, to provide access therethrough into aninternal surgical site. Access device 150 includes a proximal rim 152configured for positioning on an external side of the opening in tissue“T,” a distal rim 154 configured for positioning on an internal side ofthe opening in tissue “T,” and a body 156 extending between proximal anddistal rims 152, 154, respectively. Body 156 is configured to extendthrough the opening in tissue “T” and defines a passageway 158 extendinglongitudinally therethrough to permit access to an internal surgicalsite through the opening in tissue “T.” Passageway 158 defines alongitudinal axis 160. At least a portion of body 156 of access device150 may be flexible to facilitate insertion and positioning of accessdevice 150 within the opening in tissue “T.” In embodiments, body 156 isformed from a flexible sleeve of material including one or more layersof material. Further, access device 150 may be selectively adjustable,e.g., by rolling proximal rim 154 distally about body 156, to retracttissue “T” and/or secure access device 150 within the opening in tissue“T.” Access device 150 may further define an inwardly-extending overhang162 between proximal rim 154 and body 156 and extending annularly aboutpassageway 158.

As shown in FIG. 1B, in use, access device 150 is positioned within anopening in tissue “T” such that, as noted above, distal rim 154 isdisposed on an internal surface of tissue “T” on the internal side ofthe opening in tissue “T,” body 156 extends through the opening intissue “T,” and proximal rim 152 is disposed on an exterior surface oftissue “T” on the external side of the opening in tissue “T.” As alsonoted above, access device 150 may be adjusted to conform access device150 to a patient's anatomy, retracting tissue “T” and/or securing accessdevice 150 within the opening in tissue “T.” With access device 150disposed within the opening in tissue “T,” tissue guard 110, led by opendistal end 116 thereof, is inserted into passageway 158.

Turning to FIG. 1C, smoke evacuation system 700 is provided inaccordance with the present disclosure and is shown generally includingtissue guard 110, tubing 710, 720, a collection reservoir 730, and asmoke evacuation (or vacuum) source 740. The various tissue guardsdisclosed herein are all designed to work with system 700. Tissue guard110 and tubing 710 are detailed above and are coupled to one another,e.g., via engagement of one end of tubing 710 about exhaust connection776 of tissue guard 710. The other end of tubing 710 extends intocollection reservoir 730 in sealing relation therewith.

Collection reservoir 730 includes a base 732 and a lid 734 sealed aboutbase 732. Lid 734 defines first and second ports 736, 738 configured toreceive ends of tubing 710, 720, respectively, in sealing relationtherewith. These ends of tubing 710, 720 extend into the interior volume733 of base 732 and are spaced-apart from one another as well as thebottom of base 732. Tubing 720 extends from collection reservoir 730 tosmoke evacuation source 740 wherein the other end of tubing 720 iscoupled to smoke evacuation source 740. In this manner, upon activationof smoke evacuation source 740, suction is established through lip 126of tissue guard 110, tubing 710, collection reservoir 730, tubing 720,to smoke evacuation source 740. During use, this suction, in addition toevacuating smoke from tissue guard 110, may also suction liquids,tissue, and/or debris through tubing 710. However, as a result of theends of tubing 710, 720 being spaced-apart from one another withincollection reservoir 730 and spaced-apart from the bottom of base 732 ofcollection reservoir 730, the liquids, tissue, and/or debris aresuctioned into collection reservoir 730 and deposited therein, whileonly the smoke and other gaseous fluids are further suctioned fromcollection reservoir 730 through tubing 720 to smoke evacuation source740. As such, smoke evacuation source 740 is protected by inhibitingsuctioning of liquids, tissue, and/or debris into smoke evacuationsource 740.

Turning to FIGS. 2A-2B, another tissue guard 510 provided in accordancewith the present disclosure is shown. Tissue guard 510 is similar totissue guard 110 except as explicitly contradicted below and may be usedin conjunction with access device 150 as part of a system similar tosystem 100. For purposes of brevity, only differences between tissueguard 510 and tissue guard 110 are detailed below, while similaritiesare summarily described or omitted.

Tissue guard 510 includes a body 512 defining an open proximal end 514,an open distal end 516, and a lumen 518 extending therebetween. A lip526 extends radially outwardly from open proximal end 514 of body 512and includes a plurality of fingers 529 extending from an outerperipheral surface thereof. The fingers 529 may be equidistantly-spacedabout the lip 526 or may be spaced in any particular manner dependingupon a particular purpose. In embodiments, a continuous finger (notshown) may be annularly spaced about the lip 526.

Each finger 529 includes an arcuate channel 531 defined along an innerperipheral surface thereof configured to at least partially encapsulateor mount atop rim 152 of the access device 150. More particularly, whenthe tissue guard 510 is first inserted into access device 150, channel531 of each finger 529 aligns atop rim 152 of access device 150 and ispoised for engagement atop rim 152 when the fingers 529 are secured.Each finger 529 also includes a flange 529 a disposed at a distal endthereof that is configured to engage an underside of rim 152 to securethe tissue guard 510 in place. Finger 529 is configured to flex uponadaption of the tissue guard 510 onto access device 150 by virtue of rim152 forcing flange 529 a and finger 529 outwardly as the tissue guard510 is inserted. Upon full insertion of the tissue guard 510 atop andinto access device 150, the channel 531 of finger 529 encapsulates therim 152 while the flange 529 a snaps into place under rim 152 therebylocking the tissue guard 510 atop access device 150. The finger 529 isbiased in the locked position. The flange 529 a extends inwardlyrelative to the proximal ring 152 and operably engages the underside ofthe proximal ring 152 when biased.

Flange 529 a may be angled to both facilitate insertion and tofacilitate engagement. More particularly, an outer peripheral surface527 a of flange 529 a may be disposed at a first angle lambda (λ) in therange from about 60 degrees to about 80 degrees to encourage the finger529 and, hence, the tissue guard 510, to slip into lumen 118 and aninner peripheral surface 527 b is disposed at second angle phi (φ) inthe range from about 45 degrees to about 60 degrees to facilitateengagement of flange 529 a with the underside of rim 152 (FIG. 2B). Theshape of channel 531 may be dimensioned to conform to the shape of theouter peripheral surface of rim 152. Moreover, the height of the channel531 may be dimensioned slightly larger than the thickness and depth ofthe rim 152 to facilitate engagement.

The distal end 516 of tissue guard 510 includes a plurality ofscallop-like tabs 516 a spaced-apart annularly thereabout. Scallop-liketabs 516 a are configured engage an inner peripheral surface of body 112of the access device 150 and are contoured or scalloped to generallymimic the shape thereof. The scallop-like tabs 516 a are biasedoutwardly to maximize the opening at the distal end 516 of the tissueguard 510 and effectively secure the distal end 516 of the tissue guard510 within access device 150 thereby facilitating surgical instrumentaccess to the body cavity.

As mentioned above, lip 526 defines an annular channel thereinconfigured to direct surgical exhaust therethrough to port 565 definedin an outer peripheral surface of lip 526. Lip 526 includes distal end526 a that extends inwardly therefrom towards lumen 518 to form annularchannel 545 configured to direct surgical exhaust gas to port 565,respectively. One or more slits or passageways (passageways 113 of FIG.1C or 813 of FIG. 4A) may be defined within the inner peripheral surfaceof distal end 526 a that allow surgical gases passage into annularchannel 545. As explained in more detail below, port 565 is configuredto connect to an exhaust connection 776 of a fluid management or smokeevacuation system 700 (FIG. 1C). In other words, lip 526 is configuredas generally hollow sleeves disposed proximate the inner peripheralsurface of proximal end 514 of tissue guard 510 and is configured todirect evacuation fluids and smoke to the exhaust connection 776 and tothe fluid management or smoke evacuation system 700.

Turning to FIGS. 3A and 3B, one embodiment of a tissue guard is shownand is generally designated as reference numeral 600. Tissue guard 600includes a body 612 and a proximal ring 626 that defines an annularchannel 626′ therein configured to convey smoke, odors and miscellaneousgases from the operating cavity to port 665 and then to smoke evacuationsystem 700 (FIG. 1C). More particularly, ring 626 is generally annularin shape and includes a connection port 676 that operably couples totubing 710 of the smoke evacuation system 700. Ring 626 is configured tooperably couple to the proximal rim 152 of access device 150 (similar toFIG. 2B) via one or more mechanically interfacing surfaces, fingers 629.

Each finger 629 includes an arcuate channel 631 defined along an innerperipheral surface thereof configured to at least partially encapsulateor mount atop rim 152 of the access device 150. More particularly, whenthe tissue guard 600 is first inserted into access device 150, channel631 of each finger 629 aligns atop rim 152 of access device 150 and ispoised for engagement atop rim 152 when the fingers 629 are secured.Each finger 629 also includes a flange 629 a disposed at a distal endthereof that is configured to engage an underside of rim 152 to securethe tissue guard 600 in place. Finger 629 is configured to flex uponinsertion of the tissue guard 600 into access device 150 by virtue ofrim 152 forcing flange 629 a and finger 629 outwardly as the tissueguard 600 is inserted. Upon full insertion of the tissue guard 600 intoaccess device 150, the channel 631 of finger 629 encapsulates the rim152 while the flange 629 a snaps into place under rim 152 therebylocking the tissue guard 600 atop access device 150. The finger 629 isbiased in the locked position. The flange 629 a extends inwardlyrelative to the proximal ring 152 and operably engages the underside ofthe proximal ring 152 when biased.

Flange 629 a may be angled or include angled surfaces similar to theangles described above with respect to FIGS. 2A and 2B to bothfacilitate insertion and to facilitate engagement. The shape of channel631 may be dimensioned to conform to the shape of the outer peripheralsurface of rim 152. Moreover, the height of the channel 631 may bedimensioned slightly larger than the thickness and depth of the rim 152to facilitate engagement.

The distal end 616 of tissue guard 600 includes a plurality ofscallop-like tabs 616 a spaced-apart annularly thereabout. Scallop-liketabs 616 a are configured engage an inner peripheral surface of body 112of the access device 150 and are contoured or scalloped to generallymimic the shape thereof. The scallop-like tabs 616 a are biasedoutwardly to maximize the opening at the distal end 616 of the tissueguard 600 and effectively secure the distal end 616 of the tissue guard600 within access device 150 thereby facilitating surgical instrumentaccess to the body cavity. The scallop-like tabs 616 a each includeridges 617 defined therein and along the outer peripheral surfacethereof to facilitate engagement with the inner peripheral surface 112of access device 150.

A ground ring 680 is disposed along an inner peripheral surface 612 a oflumen 618 of tissue guard 600 and is configured to operably connect to aground wire 685 that extends along the inner peripheral surface 612 a oflumen 618. Ground wire 685 is configured to extend from port 665 and toan electrical ground (not shown). Ground ring 680 acts as an auxiliaryground return during use of an electrosurgical pencil (not shown).

Turning to FIGS. 4A-4D, another embodiment of a tissue guard is shownand is generally designated as tissue guard assembly 800. Tissue guardassembly 800 is similar to tissue guard 600 and, as such, only thosefeatures that are different will be described in detail herein. Guardassembly 800 includes a body (not shown but similar to body 612) madefrom a series of assembled parts, namely, a proximal funnel body 814, aground connection assembly 880, a distal retention body 816 and a lumen818 defined therethrough.

Proximal funnel body 814 (FIG. 4B) includes a proximal ring 826 thatdefines an annular channel 826′ therein configured to convey smoke,odors and miscellaneous gases from the operating cavity to port 865 andthen to smoke evacuation system 700 (FIG. 1C) through tubing 810. One ormore channels or slits 813 may be defined in the lumen 818 in fluidcommunication with the annular channel 826′. Ring 826 is resilient andconfigured to operably couple to the proximal rim 152 of access device150 (similar to FIG. 2B) via one or more mechanically interfacingsurfaces, e.g., fingers 829 and flanges 829 a similar to the tissueguard 600 of FIGS. 3A-3B. Funnel body 814 includes a distal portion 814′that is configured to mechanically interface with a proximal portion 881of the ground connection assembly 880 as explained in detail below.

Upon full insertion of the tissue guard 800 into access device 150, thefinger 829 encapsulates the rim 152 and snaps into place under rim 152thereby locking the tissue guard 800 atop access device 150.

The distal retention body 816 of tissue guard 800 includes a pluralityof scallop-like tabs 816 a spaced-apart annularly thereabout (FIG. 4D).Scallop-like tabs 816 a are configured engage an inner peripheralsurface of body 112 of the access device 150 and are contoured orscalloped to generally mimic the shape thereof. The scallop-like tabs816 a each include ridges 817 defined therein and along the outerperipheral surface thereof to facilitate engagement with the innerperipheral surface 112 of access device 150. A proximal portion 816 b ofthe distal retention body 816 includes a mechanical interface 816 b′configured to operably couple to a distal portion 882 of the groundconnection assembly 880 as explained in more detail below.

Ground connection assembly 880 includes a ground body 884 havingproximal and distal ends 881, 882, respectively (FIG. 4C). A ground ring883 is disposed along an inner peripheral surface of body 884 and isconfigured to operably connect to a ground wire 885 that extends alongthe inner peripheral surface of lumen 618 to ultimately connect to anelectrical ground. Ground ring 883 acts as an auxiliary ground returnduring use of an electrosurgical pencil (not shown).

As mentioned above, the proximal end 881 of ground body 884 includes amechanical interface 881′ that is configured to operably connect to thedistal end 814′ of the proximal funnel body 814 and the distal end 882of the ground body 884 includes a mechanical interface 882′ that isconfigured to operably connect to the proximal end 816 b of the distalretention body 816 via mechanical interface 816 b′ of distal retentionbody 816. Once assembled and in use, the user inserts access device 150into an operating cavity, inserts the tissue guard assembly 800 thereinand then mounts the tissue guard assembly 800 atop the rim 152 of theaccess device 150. This secures all of the components for use. The usersimply reverses the process to uncouple the tissue guard assembly 800from the access device 150.

The tissue guard assembly 800 may be assembled during manufacturing ormay be assembled on site. For example, the proximal funnel body 814,ground connection assembly and the distal retention body 816 may bealigned and assembled during the manufacturing process via glue,ultrasonic welding, screw-fit, snap-fit or any known mechanicalconnections in the art. Alternatively, the tissue guard assembly 800 maybe sold as a kit and assembled on site utilizing simplified mechanicalconnections to assemble the various components, e.g., screw-fit,snap-fit, etc.

FIG. 5 shows another embodiment of a tissue guard 1000 in accordancewith the present disclosure. Tissue guard 1000 is similar to tissueguard 600 and, as such, only those features that are different will bedescribed in detail herein. Tissue guard 1000 includes a body 1012having a proximal end 1014, distal end 1016 and a lumen 1018 extendingtherebetween. Proximal end 1014 is configured to include tubing 1010that ultimately connects to the smoke evacuation system 700.

Body 1012 is composed of an outer shell 1012 a and an inner shell 1012b. A distal portion of the outer shell 1012 a is coated with aconductive material 1032 around the inner peripheral surface thereof.Conductive material 1032 may be any conductive material or gel such asPolyHesive™ II hydrogel sold by Medtronic, Inc. The inner shell 1012 bincludes a series of pre-printed connectors 1034 disposed around theouter peripheral surface thereof that are configured to mechanicallycouple to the conductive material 1032 of the outer shell 1012 aproviding electrical continuity therebetween. Inner shell 1012 bincludes a ground wire 1022 that ultimately connects to an electricalground. The combination of outer and inner shells 1012 a, 1012 b, whenassembled, act as an auxiliary ground return during use of anelectrosurgical pencil (not shown).

FIGS. 6A and 6B show another embodiment of a tissue guard ground clip920 for use with known prior art tissue guards or any of the tissueguards described above. Tissue guard ground clip 920 may be used withany known tissue guard, e.g., similar to tissue guard 600 and, as such,only those features that are different will be described in detailherein. Tissue guard 900 includes a body 912 having a proximal end 914,distal end 916 and a lumen 918 extending therebetween. Proximal end 914is configured to include tubing 910 that ultimately connects to thesmoke evacuation system 700. Body 912 may be any standard tissue guardbody such as those described above that is configured to mount atop anaccess device 150.

Ground clip 920 is configured to clip or otherwise securely mount atopthe tissue guard 900 to act as an auxiliary return when using anelectrosurgical pencil. More particularly, ground clip 920 includes aproximal mechanical interface 923 that mounts atop rim 152 of accessdevice 150 and a flange 924 that depends from interface 923 that isconfigured to wedge between rim 152 of access device 150 and ring 926 ofproximal end 914. Ground clip 920 also includes a plastic sheath 922that extends into lumen 918 of tissue guard 900 along the innerperipheral surface thereof towards distal end 916. Sheath 922 isconfigured to house a conductive section 922 a therein that extendstherethrough. Conductive section 922 a is exposed at a distal end of thesheath 922 and extends into the inner peripheral surface of the lumen918. Conductive section 922 a acts as an auxiliary ground return duringuse of an electrosurgical pencil (not shown).

Sheath 922 and the exposed conductive section 922 a may be in the formof an elongated tube or strip or may be configured as an annular ringthat extends around the inner peripheral surface of lumen 918.Mechanical interface 923 and flange 924 may be substantially annular,e.g., a continuous ring-like shape or a discontinuous ring-like shape.The flange 924 may be a series of flange-like tabs that extend aroundthe mechanical interface 923 or vice versa.

From the foregoing and with reference to the various drawings, thoseskilled in the art will appreciate that certain modifications can bemade to the present disclosure without departing from the scope of thesame. While several embodiments of the disclosure have been shown in thedrawings, it is not intended that the disclosure be limited thereto, asit is intended that the disclosure be as broad in scope as the art willallow and that the specification be read likewise. Therefore, the abovedescription should not be construed as limiting, but merely asexemplifications of particular embodiments. Those skilled in the artwill envision other modifications within the scope and spirit of theclaims appended hereto.

1-15. (canceled)
 16. A tissue guard configured for positioning within anopening in tissue, comprising: a body configured for positioning withinan opening in tissue, the body defining an open proximal end portion, anopen distal end portion, and a lumen extending therethrough between theopen proximal and distal end portions, the body including an innerperipheral surface surrounding the lumen; an electrically conductiveground ring disposed on the inner peripheral surface of the body betweenthe proximal and distal end portions thereof; and a ground wireelectrically coupled to the electrically conductive ground ring andconfigured for ultimate connection to an electrical ground.
 17. Thetissue guard according to claim 16, wherein the body includes a proximalring disposed at the proximal end portion thereof.
 18. The tissue guardaccording to claim 17, wherein the proximal ring includes at least onemechanical interface configured to mechanically engage a rim of anaccess device to secure the body thereon.
 19. The tissue guard accordingto claim 17, wherein proximal ring includes a connection port disposedthereon and adapted to connect to a smoke evacuation system.
 20. Thetissue guard according to claim 19, wherein the proximal ring defines anannular channel disposed in fluid communication with the connectionport.
 21. The tissue guard according to claim 16, wherein the bodyincludes a retention body disposed at the distal end portion thereof.22. The tissue guard according to claim 21, wherein the retention bodyincludes a plurality of spaced-apart tabs configured to facilitateretention of the body within an access device.
 23. The tissue guardaccording to claim 16, wherein the body and the electrically conductiveground ring are monolithically formed as a single component.
 24. Thetissue guard according to claim 16, wherein the proximal end portion ofthe body, the distal end portion of the body, and the electricallyconductive ground ring are separate components assembled to one another.25. The tissue guard according to claim 16, wherein at least theproximal end portion of the body is resilient to facilitate mechanicalengagement with an access device.
 26. A tissue guard configured forpositioning within an opening in tissue, comprising: an outer shellconfigured for positioning within an opening in tissue, a portion of theouter shell including a conductive material disposed on an innerperipheral surface thereof; an inner shell disposed within the outershell, the inner shell defining a lumen configured to provide access toan internal surgical site and including an inner peripheral surfacesurrounding the lumen, the inner shell including a plurality ofconnectors disposed on an outer peripheral surface thereof, theplurality of connectors configured to electrically connect to theconductive material; and a ground wire electrically connected to theplurality of connectors and configured to ultimately connect to anelectrical ground.
 27. The tissue guard according to claim 26, wherein adistal portion of the outer shell includes the conductive materialdisposed thereon.
 28. The tissue guard according to claim 26, whereinthe plurality of connectors are printed onto the inner shell.
 29. Thetissue guard according to claim 26, wherein the conductive material iscoated on the inner peripheral surface of the outer shell.
 30. Thetissue guard according to claim 26, wherein the outer and inner shellscooperate to define a body, the body including a connection portdisposed thereon and adapted to connect to a smoke evacuation system.31. A tissue guard configured for positioning within an opening intissue, comprising: a body configured for positioning within an openingin tissue, the body defining an open proximal end portion, an opendistal end portion, and a lumen extending therethrough between the openproximal and distal end portions, the body including an inner peripheralsurface surrounding the lumen; and a ground clip including a proximalmechanical interface configured to engage the proximal end portion ofthe body to attach the ground clip thereto and an electricallyconductive section configure to extend distally at least partially alongthe inner peripheral surface of the body, the electrically conductivesection configured for ultimate connection to an electrical ground. 32.The tissue guard according to claim 31, wherein the proximal mechanicalinterface is configured to releasably engage the proximal end portion ofthe body.
 33. The tissue guard according to claim 31, wherein theproximal mechanical interface defines an annular configuration forannular engagement about the proximal end portion of the body.
 34. Thetissue guard according to claim 31, wherein the ground clip furtherincludes a sheath extending from the proximal mechanical interface, theelectrically conductive section extending distally from the sheath. 35.The tissue guard according to claim 31, wherein the ground clip furtherincludes a flange configured for positioning between the body and anaccess device when the body is engaged within an access device.